Re: Is Depression a Disease?

Originally Posted by rua eile

The chemical imbalance theory is just that, a theory, that has never been proved.

Yet it was leapt upon by pharmaceutical companies in the late 80's as a way of marketing a new class of drugs that were developed to replace the outdated monoamine inhibitors in the hope that they would be better tolerated. Not to mention the small matter of drug patent expiry which dominates r&d and the business models of the pharmaceutical industry.

Interesting comment here:

I think the attitude has been that psychiatry is a black hole and that you put money in and nothing good comes come out – at least nothing particularly novel in a long time has come out.”

In fact, the researchers who originally came up with the theory about serotonin deficiency later rejected their own findings.

Long term studies, with results made known over two decades ago, have shown the benefits over a placebo to have about a 2% differential in success rate.

Also, as is often the case with pharmaceuticals, even effective ones, they don't fully understand the mechanism of action.

No conflict of interest there then when drawing up diagnostic criteria and recommended treatment models based on drugs receiving FDA approval.

That's before we get to all the scandals related to ghost writing of clinical trial results, supreme court cases and literally billions of dollars paid out in compensation for documented adverse events ranging from suicide to homicide.

Yet they keep making them and doctors keep prescribing them. Why?

Glad you asked.

Firstly, from the pharmaceutical companies perspective there is no downside. No matter how much they pay out, they take in billions more.

If you think this is some tin-foil hat conspiracy theory, read John Virapen's book Side Effects: Death. Virapen was a senior VP in Eli Lilly and responsible for bringing Prozac to market:

The second part is much trickier and has its roots in the social causes and history of dis-ease and the desire for the medical model on the part of patients suffering from mental distress.

Firstly, the pill solution really does work in terms of offering relief. Long term studies on the placebo effect by have shown that even when knowingly taking a placebo patients find relief. Irving Kirchner, Professor of Placebo Studies at Harvard Medical School, conducted a series of studies on the placebo effect in relation to anti depressants:

Secondly, doctors want a simple solution that can reassure their patients. They don't want to waste valuable surgery time talking to someone about why they may be depressed. It isn't good for their business model or their patient workloads.

Thirdly, and this is possibly the most crucial reason why so many patients and doctors are willing to believe the hokey science behind the medical model of depression, is that is has helped enormously to remove the traditional stigma for those suffering from it.

If it is seen as an illness with a model of treatment available, it removes the traditional, but erroneous, assumption that the sufferer is somehow responsible.

That is not to say that depression is not real and often a completely valid response by the body and mind to distress, with real physical symptoms, simply that applying the medical model at best provides temporary relief that allows people to navigate themselves out of a distressing situation.

However, the fact that it fails to work in quite a significant percentage of cases, or that people can suffer recurring bouts or that even the models of dealing with it rely heavily on the supplementation of therapy or even offer it as an alternative should give most pause to think.

After all, if you were offered talk therapy as an alternative to insulin or blood pressure medication or chemotherapy, or brain surgery would you be entirely confident about the outcome?

It is hard to ignore the level of influence drug companies have:

In 2008, for the first time, Senator Charles Grassley asked the APA to disclose how much of its annual budget came from drug industry funds. The APA said that industry contributed 28% of its budget ($14 million at that time), mainly through paid advertising in APA journals and funds for continuing medical education.[26]

Re: Is Depression a Disease?

The future of AI and depression

During a conversation, humans can grasp a friend's mood or intent by relying on subtle vocal cues or word choice. Now, researchers at MIT say they have developed an algorithm that can detect if the same friend has depression, one of the most widely suffered — and often undiagnosed — conditions in the U.S.
Why it matters: About 1 in 15 adults — 37 million Americans — experience major depressive episodes, but many times go untreated.
Given a 3D eye scan, AI can diagnose dozens of diseases as accurately as a human expert. From images of tissue samples, AI can detect breast cancer as well or better than human pathologists. And it can find signs of disorders like schizophrenia, PTSD and Alzheimer's in human speech, Kaveh reports.
The latest: Tuka Alhanai, an MIT Ph.D. candidate focused on language understanding, trained an AI system using 142 recorded conversations to assess whether a person is depressed and, if so, how severely. The determinations are based on audio recordings and written transcripts of the person speaking.
How it works: Alhanai used a neural network to find characteristics of speech — like pitch or breathiness — that relate most closely to depression but aren’t correlated with one another. Then she employed another algorithm to surface patterns that most likely point to depression.

The system was most accurate when it considered responses in context, Alhanai found. She used a neural network that can find patterns across answers rather than analyze each in isolation.

The best-performing system classified 83% of the test cases correctly.

Advantages of a passive system: Someone who is depressed may lack the motivation to see a professional, said Mohammad Ghassemi, Alhanai’s co-author. Without a weighty medical conversation, an AI system might detect depression that may otherwise be missed.
But, but, but: There are early concerns about such use of AI:

Assessments should not be carried out surreptitiously, said Alison Darcy, a former instructor at Stanford University School of Medicine and founder of Woebot, a chatbot for mental-health issues.

Darcy also questioned the premise behind such systems. "Where is this huge need to diagnose people en masse, over and above what’s already available?"

In a WashPost op-ed, Canadian doctor Adam Hofmann argued that algorithms shouldn’t make mental-health diagnoses at all.

As a general rule the most successful man in life is the man who has the best information.

Re: Is Depression a Disease?

Originally Posted by statsman1

I take a very simple view; ultimately, everything in your body is chemical, including, especially, your responses to external events.

That view is difficult to argue with, however, how/why and to what degree these chemicals are released can depend on many things, in relation to a response to external events this may be determined by biological, genetic, social or cognitive factors. Not a lot you can do about genetic, but there is plenty can be done about the others.

Re: Is Depression a Disease?

Heard today that there have been 54 combat stress related suicides in England this year alone. Join the British army see the World, come home with a disease of the mind.

Yes and it's also a class issue. The upper classes that join the army get looked after for life, the working classes are left to rot away on the dole once they leave the army (if they are lucky).

"If you go far enough to either extreme of the political spectrum, Communist or fascist, you'll find hard-eyed men with guns who believe that anybody who doesn't think as they do should be incarcerated or exterminated. " - Jim Garrison, Former DA, New Orleans.

Re: Is Depression a Disease?

Yes and it's also a class issue. The upper classes that join the army get looked after for life, the working classes are left to rot away on the dole once they leave the army (if they are lucky).

True.

Many have reported difficulties claiming benefits. Especially those reporting PTSD [Post Traumatic Stress Disorder] as an ailment. Strange that,, given the British Government posthumously pardoned all those ''shot at dawn'' during the first world war having realised they were probably just shell shocked and over stressed.